Light Makes Right

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Laser surgery is far less expensive than full-scale plastic surgery and thus more accessible to people of every income and social stratum. "It's not just the young and the beautiful or the wealthy any more," says Jenifer Lloyd, a dermatologist in Boardman, Ohio. "I just lasered the wrinkles on an 85-year-old woman. Now she's dating again." Men, who account for about 20% of all cosmetic work, are succumbing too. Stan Madray, 36, who works for an entertainment company in Orlando, Fla., was unhappy with his "chipmunk cheeks that made me look older and worn." His doctor liposuctioned his cheeks and jowls, then beamed a laser under the skin to sort of "shrink wrap" his face. It was done on a Friday, and he was back at work by Monday, and nobody was the wiser, despite some swelling.

Peg Booth, a publicist in Cardiff-by-the-Sea, Calif., had her face fully resurfaced by a laser two years ago, just before turning 50, to eliminate smile lines, wrinkles on her forehead, frown lines between the brows and crow's-feet around her eyes. Before the procedures, she says, "I looked mean, and I felt older." She also felt vulnerable at the office. "People want to work with people who appear youthful, vital and exuberant. I wanted to look outside how I felt inside. Does that sound shallow?"

On the other hand, there's Carol Pighini, 43, a mother of three from Florida. Bothered by some broken capillaries on her face, she picked a dermatologist in Tampa through an ad for gentler Erbium YAG laser treatments. To her horror, her face blistered for three days afterward, her eyes were swollen shut, and pits formed in her skin. "When the laser started hurting, I asked what was happening, and they said they had 'turned it up.'" She says with a sigh, "All this because I couldn't stand wearing makeup." Lancer, the Beverly Hills dermatologist, is now removing the damage with microdermabrasion treatments; he says the Florida doctor failed to discover that Pighini, despite her blond hair, had Cherokee ancestry and was hence at risk.

So what's a confused consumer to do? Here's a rundown of what lasers can--and can't--do:

Laser Resurfacing
Carbon dioxide, or CO2, lasers have been widely used since 1994 to bloodlessly eradicate wrinkles and sun damage by vaporizing the upper layer of skin, thus stimulating the underlying collagen fibers to rejuvenate the skin. Some 170,000 people had laser resurfacing done last year, making it by far the most popular laser procedure. Though chemical peels do essentially the same thing--and cost less than the average $2,500 to $3,000 for laser resurfacing--lasers have the advantage of being more controllable, since chemicals are absorbed at different rates by different skin.

Yet laser resurfacing requires anesthesia and good skin-care follow-up, which usually involves great globs of Vaseline or special creams and a mask. Patients can be left raw and oozing for weeks or, even worse, end up looking like the Phantom of the Opera. Skin heals faster (often in a week) with the newer Erbium lasers, which are cooler and can be used on the thinner surface of the neck and chest as well as the face, as long as the doctor exercises caution. Yet even these supposedly gentler lasers can sting and, in inexperienced hands, burn and scar if they penetrate too deep. Worse, up to 20% of CO2-laser patients (and possibly some Erbium ones as well) risk ending up with whitened skin one to two years after the procedure, according to Dr. Jay Burns, a laser specialist at the University of Texas Southwestern Medical Center.

Removing Blemishes
Lasers that target only the color red have been used since the 1970s to treat birthmarks, port-wine stains and other blemishes. Doctors now believe these lasers work better in children than in adults, but they can help diminish unsightly scars and red stretch marks left over from childbirth or breast surgery. Lasers can also soften acne scars, though removing the scars altogether is difficult. Green-light lasers are effective at zapping broken blood vessels and spider veins on the face, hands and neck. But the process can be painful--just ask tough guy Mark Anfangar, 44, vice president of a Los Angeles party-equipment-rental company, who underwent some 1,000 zaps in one session alone to get rid of the angry red veins on his face. "Halfway through, I was dizzy," he admits. But it took only three days to heal, and he went back for another day of 800 zaps.